Heal Your Gut with Dr Will Bulsiewicz

I don't really think about these fibers, and I never counted. Grams of fiber. What I do is very simple. I count plants. I step into the supermarket. There's that beautiful, fresh produce section. Boom. I'm counting plants. I mean, I buy the legumes. And the whole grains. And the seeds and the nuts. Not necessarily fresh produce, but guess what? Boom. I'm thinking about diversity of plants. To come home, I step into the kitchen. I'm a little lot more clumsy than you are. The food doesn't look as beautiful as your food, but that's okay. I'm thinking about diversity of plants. Right? Like a simple. Idea here, Ruby, I got three kids. I'll call my kids into the kitchen with me. We're a normal family. We're going to put. Together some pasta sauce and some pasta. Like, you could have pasta and sauce. Is there anyone that believes that that's a healthy dish? I mean, you could do worse, but I'm not going to contend that that's the healthiest dish out there. Flip side, you take that sauce. You get it simmering, You open up, you flip, open your refrigerator, like, hey, are eggs. You just ask yourself this question what tastes. Good in tomato sauce? And you start pulling stuff out. And you got the onions and the garlic and the mushrooms. And. The peppers, zucchini, you know, the basil. You keep going down the line. I know. I know that there are people at home whistling right now. They're shouting. At the. Shouting. At their radio or. Whatever. Oh, but Dr. B, you would add this, you would add this. Okay. Yeah, yeah. Get it in. There. It's simmer. It smells fragrant. It's attractive. It looks beautiful. My kids, they're excited to be a part of it because they help to cook it and you serve it up and guess guess who's the happiest? He's got. Microbes. They're doing a kick. Like they're dancing Irish dancing down. There he goes. You just took tomato sauce that was only going to feed one of them. And now you brought in this out and you didn't even try. And you got eight different plants. In your in your tomato. Sauce and. You're feeding a diversity of microbes. And so in the in the market, in the kitchen. At the dinner table, I. Just I just want you to hear my voice. Diversity of plants and yeah. You make this a central piece of your diet. Doctor's kitchen recipes, health, lifestyle. Well, thank you so much for joining the show. Super, super stoked to have you here. And apologies for last time as well where we had it booked in. Our listeners might know this, but I sent you a voice note. I think it was like the day before and I was like, Hey man, I'm really sorry to do this, but it's just before my wedding. It's proper crazy right now. Can we please reschedule? And you were so sweet about it. So thank you so much already. Already do appreciate that. I mean, first of all, it's a pleasure. To be here. I feel like we're old friends, even though we're just kind of in some ways getting to know each other. But. You know, getting married, that's a special that's one of the most special. Days of your life. And you'll always remember that day. You'll always remember those moments. And it's one of the few times that you bring it together. Everyone that loves you. So it's it's a cool thing. And. You know, it's to me, the only one that. Was bigger in my life was the day that my children were born. That that's just the absolute top. But it's really cool. Yeah, well, I look forward to doing that one day at some. Yeah. Yeah. Just a little pressure. And I'm not. You just. You just got married. I'm not. I'm not trying to tell you. You got to do anything. I'm just saying at some point, perhaps. Yeah, yeah. No, I. I'm still getting over. I wouldn't call it trauma of the wedding, but just like, you know, the craziness of it and everything, and it was just super enjoyable to have everyone down. I like, you know, my wife's Australian, so all of her family are over. And it was a very unique scenario to have everyone in the same room. So yes, it's super stoked that we could make that happen. I'm look, we were just chatting before we started going live about a bit about how our stories are sort of intertwined in that we're both doctors, we both wrote our books whilst practicing our full time, but what we didn't get into is actually how you got into nutrition in the first instance. It's relatively unusual. I'd say it's becoming a lot more common now, but it's relatively unusual to have doctors go through that conventional system and have a good depth of knowledge around nutrition. So what we we start by talking a bit about your story and what led you down this path in the first place. Yeah, I mean, Ruby, I feel like these things. Need to change. I don't know how we could look at what embodies human health and ignore nutrition, which perhaps is the largest piece of the entire pie. But, you know, to kind of. Go back in time about ten years ago. I was in my medical. Training as a gastroenterologist, so I was already board certified as an internal medicine doctor. I could have been in practice, I could have not been in the training system, but I wanted to become a specialist. And during this. Period of my life. I know you can relate to this. I was. Working. Basically my entire. Life was consumed by the hospital. There just was no. Other space for anything else. I barely had time to do my laundry and there's six days a week, 18 hours a day, sometimes 30 hours in a row. And when you're in that place, number one, you're just trying to survive. And number two, there are these little fleeting. Moments. That make you feel kind of good, like you have some. Self-Worth. And you have to lean into those things because they're what get you by. When you're having a hard. Time. And for me, that was food. I found that. A. Unhealthy but very tasty junk food diet, you know, fast food diet. It fit so perfectly. It was quick, It was low effort, it tasted good, and it didn't cost any money, which was perfect because I didn't have any money. And those choices through my twenties, you know, when I was in my early twenties. I could get away with it because I, I guess it was just age. I had a good metabolism. So it didn't really show up. And so I kind of thought that I could continue. To get away with this. Forever. And the problem. Is that the trade off or the compromise that I made was more of a, Hey, this isn't going to hurt you right now, but it will hurt you over the course of time. It will start to build up and cause trouble for you. And so. That trouble. Came for me when I turned in around 30 years old and. I felt like I was in a really bad place. Like there's this. Moment, Ruby, where I mean, I can't say that, like, this came out of nowhere. This was building up over time, but I kind of feel like there is this moment where I'm looking in the mirror and I don't recognize the person in the mirror, you know, how did I become that? I was. 20 kilos, 50. Pounds, more than 20 kilos of, I guess like 23 kilos, 23 kilos overweight, £50 overweight. I was I was depressed, I was anxious, I had high blood pressure. I had high cholesterol and extremely low self-esteem, which is kind of bizarre to people that don't understand what I was feeling like because I was accomplishing all of my professional goals and more. But I didn't really feel good about myself, and I knew that things needed to change for me. And the strange thing is that I. Dedicated like at this point I'm in my early thirties. So like nearly. Half of my life already. Has been spent pursuing this goal to become a medical doctor for the purpose of healing and helping others. And I'm the one who needed the healing. I'm the one who needed the help. And I didn't want my own medicine. I didn't want to treat myself using the techniques that I had been taught. Again, like I was a board certified internal medicine doctor. I could have been my own doctor and I didn't want those things. And so I wanted something that. Actually would fix the problem and get to the root of it. And so I tried exercising like, I'm sure. You've been there. With me, you know, sort of like a. Typical early thirties, almost like a shock, right? Like. I'm just going to go to the. Gym and work out so hard. That it doesn't matter what I eat. Or what I do. I will I will, you know, transform my body. And I did get stronger and faster and things like that. But I did not transform my body nor restore my health. And clearly I needed something else. And what ended up becoming that thing was nutrition, was changing my diet, changing my diet completely transformed my life. And it was a a flip towards a plant based diet. It was not, by the way, a flip towards veganism. From my perspective. This was the the realization that maybe by eating more plants, that maybe I would feel better. And, you know, a quick little story. Yeah. There was a day that. Started. And again, this was not a light switch. This was like I took years in my transition. Yeah. But there was a day where this started. I was on my way home. From work and normally I would just go to the local fast food joints called Hardee's. And at Hardee's you could get for $4. I'm not kidding about 2000 calories. And that included a double cheeseburger. Okay, four. Bucks, a double cheeseburger, a chili cheese dog. It did have some onions on it. So that was. Redeeming. French fries, a soda. I would make that a Diet Coke because that's healthy. And also an apple pie. Oh, wow. So what? Yeah. Then So. Well, we like to make our fast food cheap here in the States. So anyway, yeah, clearly. I, I made the. Decision to divert away and I diverted home. But I still needed something that was easy. I'm not a gourmet chef. I'm not claiming to be able to do the things that you can do. Ruby and Sushi. So I diverted home and I was like, Well, what? What am I gonna do now that I'm here? Like, what am I going to do? I'm hungry. And I pulled out the blender and I just loaded it up. I didn't even, like. Look for a recipe. I just threw. Stuff in there and added some water and some ice. Yeah. And buzzed it. And it was like, you know, three tall. Glasses full. Of smoothie. And, I mean. This is being completely real. I felt so good because I think normally when I would eat, I had gotten so used to feeling hungover. So I felt. So good after drinking that smoothie, so. Light, so fresh, so energized, it almost felt like you could feel it through my blood. And maybe you could. But anyway, that, you know, I think that the sort of context that's. Important with that is that. When you feel like I think it helps me as a. Doctor to understand what my patients feel like, they don't feel well. And when you feel so unwell and then you find something. That makes you feel better. You have to do it again because you just want to feel better. And that's kind of what happened. I just did it again and again. Yeah, yeah, yeah. That's epic. I mean, like again, there's so many similarities between I want to hear. Tell me about illness. Yeah, Yeah. When I, when I got ill, it was a lot earlier actually. It was literally just when I qualified as a junior doctors I was 24, three months into the job. You know, it's like no time to sit down, slips all over the place. Stress is super high. You're learning stuff on the job, you're eating from the hospital canteen that's usually beige and stuff covered in cheese or whatever. And then you have like fry ups, typical fry ups. And the hospital is like a very popular hostile breakfast. That's when I started having my palpitations. I got diagnosed with atrial fibrillation, I got admitted to the hospital and my heart rate was going at 200 and that was the start of me being able to empathize with patients because I knew what it was like to be vulnerable. I knew what it was like to be that person literally in the bed. And I started making those changes and just like it wasn't like a light switch. It was steady, gradual things that I started adding. I started with breakfast, I started having oats, I started making my lunches and bringing it to work. And that's when I saw a recovery over a period of a year and a half to two years. And it was it's funny you said something in the story that really hit home about how you didn't want to take your own medicine. You didn't want to take those those blood pressure pills. You didn't want to take those, you know, all the rest of the things that we are very important in conventional medicine, but they're not treating the underlying root cause. And you talk so eloquently in both of your books about getting to that root cause I want to dive into and a bit. But that really stuck with me because, you know, if I did want to take those medications to cease my arrhythmias or reduce my heart rate, then I'm sure none of my patients would have really wanted it. They wanted to find answers, and I wanted to find a route to healing themselves. So I really appreciate you sharing a story. And that's I'm sure that's going to be super helpful for a lot of people. Well, I think it's I think it's I think it's so true. And by the. Way, I'm not making an argument against conventional health care. I think that it's very important that we have. Of course, you're right. But but I think that the I think that the problem that I see is that we need to we need to make it more holistic. We need to look at the complete person and we need to understand more than just just diagnoses or just symptoms and having algorithms and tests and and pills and procedures. We need to get to a place where. Yes, we. Do have those things. But you know what we're going to also focus on? You're on your diet, your lifestyle, your sleep, your stress. These are very big and important things and how people feel in their health. Yeah. Yeah, absolutely. And I think having the time to dive into those things as as well, I mean, one of the things that I'm currently involved in at the moment is a drive to change hostel food, not necessarily for patients, just yeah, it's actually for hostel staff and patient visitors because right now I'm not assured is like in a hostel systems in the US. But when you go to a hostel in the UK you're usually met with a Starbucks with all their sort of unhealthy beige options that they have, like calzones and refined breads and all the rest of it, and high sugar drinks, or you have a hostel canteen that generally doesn't have very healthy ingredients. It's usually fried fish, chips, beans. Not not the kind of beans that you're talking about, the kind of things that are. Loaded with these that are mostly sugar and mostly sugar, because you have to be. Yeah, yeah. Those those going to beans and jack potatoes and that kind of stuff. So what I'm trying to do is actually help people who are in similar experiences to, to ourselves actually look at improving themselves before they reach that threshold where disease sets in, where they get their first diagnosis, and then they're on the trajectory of, you know, getting the next one and the one after that. So, yeah, I love that. I love that we have the same issue. In the States. My training for my internal medicine residency was in Chicago at Northwestern University, and we had a Starbucks in the lobby. We also had three restaurants in the cafeteria. It was like more than a canteen. It was there were actual restaurants. And, you know. And you know, how how can how can we expect our doctors. To be good at what they do and to be sharp and be focused and, you know, go through what is very rigorous dealing with the health care system on a daily basis. If their body is not in a place of strength because their diet is poor. And they are not sleeping and they have intense levels of stress and they don't have time for exercise. Right. We have to I love what you're doing because we have. To apply this. To this. Like let's call them a vulnerable population. It doesn't matter. How much money they make. Right? It doesn't matter the very vulnerable population. Because the demands of the job are tearing their body apart. And so I think I think that's tremendous. And I'm really excited to hear that. Yeah. Yeah. I'll let you know how we get on with it. There's definitely a lot of support and it's a in the UK generally doctors who work in orchestras don't get paid anywhere near as much as the states. There isn't that sort of like trajectory of although you guys have like a ton of debt when you guys leave med school as well. But the there's yeah, a lot of debt. Yeah there is, Yeah. Yeah. I've got a few friends of mine who are like anesthetists and stuff and they're just about paying off their student loans. This is a very, very different system. Still paying. But yeah, there you go. Yeah, it's testament. Yeah. And I had my forties. You know, despite. Yeah. Look on the camera. Yeah. So that fiber body so replace like. Yeah but yeah so like yeah a lot of. The the staff that we also certainly want to cater for the the administrators, the porters, the nurses and everyone else because you're right they are vulnerable population and actually looking at UK data there are more risk of things like cardiovascular disease, depression, dementia than the general population. So you have to start there. And and I also have this sort of idea of like you have to treat our medical staff as if they are athletes because what they're doing a pretty incredible feats of, you know, long hours and having to make decisions in the middle of the night and stuff. And you want someone to be as well rested and as optimal as possible with comes to their nutrition or the other factors of lifestyle. So, yeah, I'll definitely keep you up to date with that. I love that. And two quick things I just. Want to say before we move on. First of all, the number one cause of death among cardiologists is heart disease. That that to me says, Oh God, yeah. And number two, I just want to. Give a quick shout out because you're kind of alluding to this, but I want to take this quick moment to shout out to the nurses and the texts and the respiratory technicians and the other hospital staff, because this pandemic was a tremendous challenge to these people. And it was hard. And I. Think it's important as a society because. People are not actually inside the hospital like, for example, in the. States. And due to privacy. Laws, like they can't bring cameras inside the hospital and show what's going on. But I can tell you, having been inside the hospital, these are the heroes. And it was actually. Very easy for me as a doctor relative to what the nurses had to go through because they were the ones in the room with the coughing patient. So I just want to say that real quick. I know because I know you feel that way, too. Oh, yeah, absolutely. Absolutely. And I completely agree with that sentiment. You know, a lot of the time when I was in Annie and even in ICU during the first wave, I was in a room, you know, like calling patient families, having discussions with some of the other senior doctors, whereas you had all those people that you just mentioned here, the ICU nurses, the ward nurses, everyone who were literally breathing the same air in these closed wards for hours at a time. So. Absolutely. And actually, on that note, let's talk about some of the interesting data that came out of well, you wrote about it in your book, actually, in the in the latest one about how those who had a greater diversity of parts in their diet or high fiber intake were less risk of the severe symptoms of COVID 19. I wonder if we could start off with that study. Yeah, it's kind of interesting, Ruby, because I think I am, you know, in research and clinical research, it's really pattern recognition. We're looking to see a pattern that starts to become reproducible. And when you can see it in. Different layers of the. Evidence, like there's no. One study that proves. Stuff. We need multiple different. Studies from. Multiple different. Angles. And those multiple different studies are all kind of pointing in the same direction. And that's when you know. That you have something that's strong and believable. So that's what I like to look for. And I noticed a. Pattern starting to emerge already in 20. 20 where they would. Do microbiome studies in people that had COVID 19. And this was a paper. Published initially in the journal Gut, which of course is the top gastroenterology journal in Europe. They did microbiome. Studies in people that had COVID 19. And what they noticed that I was really taken aback by. Is that there was a distinct. Difference in the gut microbiome pattern. Of those who had COVID 19, and it persisted after the virus was gone. Now, real quick, I'm sure. That your audience is quite facile with the microbiome, but just in case there's some listeners who don't really know what we're talking about here, let me just give a quick run through. So it's very. Interesting what's happening in the world of science today. I feel like we're going through a scientific revolution, and the reason why is because we. It's not that we. Discovered that we have these invisible single cellular microorganisms that are a part of our body, like in on our skin, in our mouth, and most concentrated inside of our colon, which is our large intestine. And in that spot we call them the gut microbiome. It's not that we just discovered this. We knew they were there. We just we didn't really think much of them. We figure they're just like they produce bowel movements and, you know, gas, so why would we care? But new technology. Developed in the laboratory around 2526 that allowed us for the first time to take a look. At these 38 trillion. All right. That's a big number, 38 trillion. Microorganisms. That live. Inside your colon. This number is literally if we were to take all of the stars that exist within our galaxy. We would need three. Hundred and 80 galaxies full of stars that we would insert into our body to match the number of microorganisms that we have living inside of us right now. Literally, right now. As I talk to you, I'm holding up my thumb up for the camera in case anyone wants to look at that on my thumb right there. There are as many microbes as there are people in the UK. So I'm looking at a little. Crazy. Little island that you guys. So anyway, this microbiome. It's it's. Important because we have discovered that it's connected to many of the parts that are. Very relevant to human health. So. That is digestion. That's where I sort of came in. I became very interested from a digestive perspective. But it's actually so. Much more than that. It's also our metabolism, our hormones, our mood, our brain health, our immune. System or energy levels. So we have discovered. This gut microbiome is really important. Okay, that's that's gut microbiome. One on one. Coming back to the COVID 19. They had this. Paper published in Gut, and they looked at those who had COVID 19 and those that did not, and they found that those who had COVID. 19, there was a shift in. The microbiome towards more what we describe as inflammatory microbes, microbes that create inflammation. And less. Of microbes that we would describe as anti inflammatory. But there was a specific. Thing about those anti-inflammatory gut bugs that. Went missing. Those gut bugs are known to be the ones that help us to digest our fiber and produce what are called short chain fatty acids like butyrate fiber. 101 Here we go. We'll jump right into this. Oh, go ahead. Yeah, I'm going to just because I think a lot of people hear the word fiber and they think of like one thing. And I think what you've done. Yeah, yeah, exactly. Yeah. They think they can prove it. And I think like giving giving folks a framework to think about fiber. Okay, well, fiber is the different subtypes. How we differentiate between those, I think that would be really useful for people when they think about it in the context of what you've just described as the microbiome. Okay. So sorry. For the diversion for those who are really interested. In the punch line and the COVID 19. If you if. You already are a fiber expert, you could probably jump ahead for minutes. And hear the punchline and COVID 19. But fiber. Is quite fascinating because we. We really thought of this as a. Boring nutrient. There continue to be. People who say fiber is not essential for human health. I find that to be an interesting statement. And the. Fiber is actually going through a. Renaissance. In a way. Because we. Discovered, like. We thought. That fiber was just in the mouth and kind of sweeping through and pushing junk along. And then kind of. Torpedoing out the other end as a movement like that. That's the story of fiber that we were sold. But actually. The story is very exciting. Because fiber we as. Humans lack the enzymes to digest and break down fiber. Which is actually a blessing because. Then the fiber. Goes undigested and arrives into the colon the exact. Same way that it went into your mouth. And there in the colon or the 38 trillion microbes. And guess. What? Their preferred food is fiber. Guess who has the enzymes. To break down? Fiber, Your gut microbiome. They have thousands, we believe tens of thousands of unique enzymes that us humans don't have, and they do. And this allows. Them to then get to work. As teams, like they literally work as teams. Different ones step up at different moments using their enzymes to unpack the fiber. And fiber undergoes a transformation where it stops being fiber and. It reemerges as this beautiful thing. The short chain fatty acids. Butyrate acetate it. Now, these short chain fatty acids, if you haven't heard about them. It's time that you do because they are. In my 20 plus. Years of studying. Medicine, the most anti. Inflammatory compounds that I have come across. And we can see their healing effects in action throughout the entire body. And we will be talking about some of those healing effects. But suffice it to say. That I mentioned earlier the gut microbiome is connected to your digestion, your immune system, your metabolism, your hormones, your mood, your brain health, every single one of those things. We could sit down and unpack how short chain fatty. Acids. Are relevant to your digestion, your immune system, your metabolism, your hormones, your mood, your brain health. So this is a powerful and exciting thing. And one last quick caveat. Before we come back to COVID 19. We're just not eating fiber. So I'm here and I'm talking. About how. Wonderful and exciting this is yet in the United States. So we are. Particularly bad eaters in the United States. We are probably the worst. We 95%. Of Americans are not getting the minimal recommended amount of fiber. In the U.S.. And or in our country. The Institute of Medicine recommends that the average woman get 25 grams of fiber. She's not. She's getting about 15 and a half. The average man is recommended to get 38 grams of fiber. He's not. He's getting about 18. We're way low. This is this is perhaps our most. Pressing nutritional deficiency from my perspective. And fiber is not hard to find. It's a carbohydrate. So when we categorically vilify carbs, we're vilifying fiber. It's a series of. Sugars linked together in a very complicated way. And there are many, many different types of fiber to try to describe. So I was a chemistry major in college, and when I look at fiber molecules, I'm like, okay, I don't even know where to start. Like, what is that? I just it's so complicated. I get a headache. So to make it simple, we've sort of broken fiber into two main categories just to really simplify it as much as we can. Soluble fiber and insoluble fiber. Insoluble fiber means that if you put that into a beverage, like if you put it into a coffee or tea and you stir it, it will actually dissolve. It will disappear. And insoluble fiber, which is what we could refer to as roughage, that or grit that part, it will not dissolve no matter what you do, no matter how warm the temperature of the beverage is, it doesn't it doesn't matter. So these two main categories of fiber, they're a little bit different. Soluble fiber is the fiber that feeds these gut microbes. And insoluble. Fiber largely. Passes through the intestines and does have some. Effects, such as on our cholesterol. But you don't need. To worry about these. Distinctions. What you need to know as the listener. At home is very simple. Fiber is good for you. Fiber feeds your gut microbes. Fiber creates these anti-inflammatory compounds. And you find it in plants, All plants, fruits, vegetables. Whole grains, seeds, nuts and legumes contain fiber. And I'll add one more. That's mushrooms. Mushrooms are not technically plants, they're fungi. But we're going to make them honorary plants because they're actually a great source of fiber. So anyway, we want to. Be eating more plants, and the average American diet is about 10% plant based. Know. My understanding. Is that in the UK only about 10% of. People I said 5% in the U.S.. In the UK, only about 10% of people, maybe 12%, are meeting the recommended amounts of fiber. So this is. Not just a U.S.. Junk food problem. This is a global urbanization, Western society problem. And so. Anyway, bringing it back to COVID 19. They noticed that they were missing the microbes that digest the fiber. When people had COVID 19. It turns out. That these are the same microbes that produce short chain fatty acids. And this was highly compelling. To me. Because I knew at the beginning of the at the beginning of the pandemic, I was like trying to figure this out. Like, what? What is going on here? What are we going to do about it? And actually brought. Up a. Piece. That I submitted to some of the big newspapers here in the States, like The New York Times and The Washington Post, and I understand why they didn't publish it. But I was convinced. That fiber could be part of the story. Because there already. Was data granted from an animal model where. They would infect. The mouse with a respiratory virus. Not COVID 19, but a respiratory virus. And they would feed. The mouse a high fiber diet. And the scientists in this. Laboratory study. They thought that the high fiber. Diet would actually be bad for the mouse because fiber reduces information. So if it reduces inflammation, then it would reduce your ability to fight off a virus. And they actually found the complete opposite. The mice that received the high fiber diet, they lived longer, they had less severe manifestations of the virus. And they actually tested. The capacity of their lungs to expand. And they found that they were more capable of expanding their lungs on the high fiber diet. So this led these scientists. To dig deeper and try to understand this because they were surprised. And what they discovered was that. Specifically when these. Mice were fed a high fiber diet, the fiber came into contact with the gut microbes. The gut microbes in the mouse released short chain fatty acids, the short chain fatty acids traveled through the bloodstream to the lungs. And in that place helped to shape the response of the immune system, where it helped to get the appropriate immune cells that fight viruses into the fight. So let's get these guys. On board. ASAP. And at the same time. These short chain fatty acids were. Suppressing the. Unnecessary sort of. Excessive immune response and keeping them in the barracks. And so fascinating short chain fatty acids and. Fiber can shape the response of the immune system in a battle against the virus. So this suggests. That dietary fiber. Between the gut. Study showing that we were missing the microbes that that produce or chain fatty acids in severe COVID 19. And between this. Animal model based study, it suggests that. Dietary fiber may be really important. And it all came to fruition again with years of evidence. It all came to fruition in a subsequent study. Of multiple countries, including the UK. Where they looked at hospital based workers. Early. In the fight against COVID 19. And these were. Pre-Vaccination. There was no vaccination at this point. And they asked the question what happened and what were you eating? And what they discovered was that the people who had that were the least likely to develop COVID 19 and to have. Moderate or severe COVID 19 were the people that were consuming a predominantly plant based. Diet. The second. Most protected were the people consuming a pescatarian diet. And the least protected B in this case, most likely to. Develop moderate or severe COVID 19. Were those consuming a low carb diet Because bearing in mind, like I'm kind of speaking about the ketogenic diet right now, bearing in mind that I mentioned a bit earlier, fiber is a carbohydrate when we cut carbs. Generally speaking, unless. You are a nutritionist and really good at what you're doing, generally speaking. You will be cutting fiber in the process of cutting carbs. And that's what we saw in that study. Yeah, No, no. Super interesting. I remember when they came out and I think inherent in and a lot of studies are that the factors that make the number of confounders that you might find in someone with a predominantly plant based diet that might have all the other healthy factors and stuff and you try and control for those for sure. But that really did raise a few eyebrows. And I think it speaks directionally to your point about the need more fiber in our diet, considering we have such low consumption across the population in general. One of the other things that I wanted to pick up on, actually, as you alluded to in your explanation as to why the researchers were surprised about the anti-inflammatory effect potentially dampening the immune responses, because inflammation, although it has like quite a sort of bad rep, is a very important part of our immune response. So we use inflammation, our immune cells actually generate inflammation when they fight off pathogens. So but everything's in moderation. So it's really about balancing inflammation rather than removing all sorts of inflammation altogether. Super fascinating studies. And just to sort of summarize, I guess, you know, fiber, multiple different types, the overarching opinions to try and get as much of those different types of fiber and diversity as well. Those create short chain fatty acids as proportionate beta. Right. And those have got nourishing effects for your chronic cells. They have the impact on immune system. They modulate inflammation in your intestines in general, and they have all these other factors as well, which are, I think, absolutely fascinating in terms of the soluble versus insoluble. Other further subtypes of fibers that you like to think about when referring to specific ingredients or anything like that, or or do you just sort of go for as many different types as possible? Is that sort of like the way you think about things whenever you give advice to patients? Well, so I. Prefer for us to find approaches that are number one, very easy to conceptualize. Number two, you can turn them into a game and number three, you can make them fun. Because I truly believe in and I think that you feel. This way to be. Like food is. Meant to be enjoyed. And I have a problem. When we create rigid programs and rules that make people so neurotic about what they're. Eating, that that stops. Being fun and stops being enjoyable and starts being this rigorous thing. So I like to simplify it. And the you alluded to. This, but I just want to unpack this real quick. So there's literally, we. Believe, millions of different types of fiber that exist in nature. We don't even have an exact estimate. We don't know. But we believe that. There's at least millions of different types. And you have to understand. These microbes that live inside of they are varied, they are diverse. There are many different ones. They have they're almost kind of like us. They have. Different. Skill sets, like specific ones do specific things. They have clicks or circles of friends. That they run in. You see them hanging out together. They kind of have different. Personalities, like some of them are grumpy. And they have different dietary preferences. So now I suspect that you. And I like people, might describe us as eating a very similar diet. Yet I don't think that's true because we have different dietary preferences right? We might share some certain foods and really love this those same dishes. But generally speaking, there are many different ways that we can come about making those choices. So we all have different dietary preferences. These microbes are like that. So we want as much. Diversity within our microbiome. Diversity is the measure of strength and resilience. And part. Of that is because when you have a diverse microbiome, you have all of these different. Skill sets willing and capable. Of contributing to your. Health. In order to. Feed a diverse microbiome, we need to acknowledge that there are diverse dietary preferences, and if fiber is there preferred food, then we need to feed them a diverse mix of fibers. And this is where the concept of diversity. Within the diet has really risen up in the last few years. And I want to briefly acknowledge some of my colleagues. That I, I love and have great respect for in the UK, such as Meghan Rossi or Tim Spector. Who are doing very similar things and messaging. In a very similar way to me. And I find that to be an interesting but. Also encouraging thing because we're looking at the same science. There was a paper that came out called the American Gut Project, and the American Gut Project was far more than just American. It was actually a global project. That allowed us to. Take a look at the gut microbiome in connection with diet and lifestyle. And ask the question what are the factors associated. With a more healthy gut microbiome? And when they. Performed this analysis, I'm like, I. Don't know what the lead author, Rob Knight. What he eats, but I'm pretty. Sure he's not a plant based. Guy. I think that he's a scientist, right? I think he's a scientist. I think that he wants to do good science. I think that he wants to shift paradigms and perhaps like win a Nobel Prize someday. And when they performed their analysis, there was one thing that was the most important factor in association with a. Healthy, diverse microbiome, and that was the diversity. Of plants. In your diet and specifically in the in their study, the number. Was 30. 30 different plants. Per week, per week. Now, this may sound. First of all, intimidating. Don't be intimidated if you're less than 30, it's okay. This is an idea about moving the needle. And so it's not that you have to be at 30. And it's also not that. 30 is a magic number. Like 29 is good. Too, and 31 is just a little bit better. The point is that. Our food system does not want us. To actually have a diverse diet. The food system, it's easier for them to. Consolidate into just a. Couple crops. And then just mono crop. The heck out of it. And that is is. Why corn and soy. And when you step into your market, 75% of. The calories that are coming from plants in your market are from those three. Foods. Wheat, corn and soy. So it falls to us if we want. A diverse diet to feed and nurture a diverse microbiome. It has to be intrinsic, it has to be self-motivated. And this is where the idea. From my perspective, I know that. Both Meagan and Tim have been out there bang in the same drum. The difference being there, being in and in London and I'm over here banging in the States. But they're out there being in the same. Drum and and spreading this. Message that when we when we when we emphasize and focus on eating. A more diversity of plants. Number one, you will get your fiber. Number two, you will naturally. Gravitate towards plant based foods, meaning that they will rise above current consumption and become a more dominant part of your diet. Number three. Every single one. Of those plants has unique nutrients. Beyond just fiber to feed and. Nourish your body. That includes polyphenols, which, by the way, are prebiotic. Prebiotic means they feed your microbiome. Fiber isn't the only thing that feeds your microbiome. Polyphenols due to it also includes resistant starches in some cases that are prebiotic. And vitamins and minerals and these special chemicals called phytochemicals. That you find in. Plants. In many cases, the pharmaceutical industry tries to. Snatch them up. And turn them into drugs, but they've already existed. They've already been there for thousands of years, millions years. So number three, you get all of those beautiful things. And number four, you are eating the ideal diet to support and nurture your gut microbiome. And so to me. It's not like a rigid thing. Rupi The original question is. So first of all, by the way, I apologize for the divergence everyone. But the question. The original question was. Like, how do you think about these fibers? Like, how do you approach this? And the answer is, I don't I don't really think about these fibers and I don't really count grams of fiber. I've never counted grams of fiber. What I do is very simple. I count plants, I step into the supermarket. There's that beautiful fresh produce section, boom, I'm counting plants. I mean, I'm by the legumes and the whole grains. And the seeds and the nuts. It's not necessarily fresh produce, but guess what? Boom. I'm thinking about diversity of plants. I come home, I step into the kitchen. I'm a little lot more clumsy than you are. The food doesn't look as beautiful as your food, but that's okay. I'm thinking about diversity of plants. Right? Like a simple idea here. Rupi. I got three kids. I'll call my kids into the kitchen with me. We're a normal family. We're going to put together some pasta sauce and some pasta. Right? So, like, you could have pasta and sauce. Is there anyone. That believes that that's a healthy dish? I'm not going to contend. I mean, you could do worse, but I'm not going to contend that. That's the. Healthiest dish out there. But flip side, you take that sauce, you get it simmering, you open up, you flip, open your. Refrigerator, like. Hey, yeah. You just ask yourself this question what tastes. Good in tomato sauce? And you start pulling stuff out. And you got the onions and the garlic and the mushrooms and the peppers and the zucchini and, you know, the basil. And you keep going on the line. I know. I know that there are people at home listening right now that are. Shouting the shouting. At their radio or whatever. Oh, but Dr. B, you would add this, you would add this. Okay, yeah, get it in there and simmer. It smells fragrant. It's attractive. It looks beautiful. My kids, they're excited. To be a part of it because. They help to cook it. And you serve it up and guess guess who's the happiest? He's got microbes Like they're. They're doing a kick line. They're dancing, right? It's like Irish dancing down there because you just took tomato sauce that was only going to feed one of them. And now you brought in this out and you didn't even try. And you got eight different plants. In your in your tomato sauce and you're feeding a diversity of microbes. And so in the in the market, in the kitchen. At the dinner table. I just I just want you to hear my voice. Diversity of plants and you make this a central piece of your diet. Yeah. No, that I think that's a really good framework of thinking about it. I've never measured my fiber. Intake, so I just sort of. I wrote two books about it. Yeah. Yeah. I'd just like, you know, focusing on diversity, the flavor, fullness of the ingredient, seasonality, all that good stuff. It's definitely something that's for the forefront of what I think about personally and what I what I talk about. And let's dive into some of the other sections in the book that I think are going to be most pragmatic for people because I get this a lot right. I get Dr. Whippy, I get what you're trying to say. You know, I need to eat more wholegrains. I need to have more fiber. But you know what? Those don't agree with me. I bloat. I, I, I feel nauseous. I'm pretty sure I've got food allergies to something. I just don't know what and what your book is. I'm exceptionally well is talk people through the basics of determining what works best for you. So the difference between I mean, we could start off with, you know, the difference between a food intolerance versus a food allergy and then the general sort of gold standard framework of how you determine what threshold you have, all of these words that use what thresholds you have for certain ingredients such that you can enjoy the diversity of of foods out there whilst also being cognizant of, you know, okay, what what is actually working for you Because within the mixture of trillions of microbes, that's going to give a different fingerprint for every single person that's going to determine what they what they enjoy, what they can enjoy, and what's going to be healthiest for them. Yeah, yeah, totally. I think it's important. To start off with the message that there is no one size fits all. And I don't. I don't. Have the intent or desire to shoehorn people into a diet that they hate and they feel doesn't work for them. But Doctor B said, I have to do it. No. I don't want you to actually do that. I want you to love your food. I want you to enjoy it. I want you to salivate when you think about it. I want you to be excited. But I also. Want it to nourish your body, nurture microbiome, and not require you to compromise on your health and have your health a long term. And you know, we've well into your eighties nineties when hundreds dancing and celebrating and enjoying time with your family. So that's what I that's my vision and. So how do we get there. Well this barrier. This barrier does exist and the motivation for writing my second book, The Fiber Fields Cookbook, came out of the response to fiber fuels. Was it my plan? I didn't know. This was going like I didn't have a two book plan. I didn't know this was going to happen. But I wrote. Fiber Fueled and it came out in the States in May of 2020, right in the beginning of the pandemic. I had zero expectations. Many of the great podcasts here in the States. I had to cancel my participation because. Of the pandemic. So like Rich Roll, I had to cancel. And the book came out. And I think it struck a struck a chord. And here we are, you know, two years later, and it has sold over 250,000 copies. And with that. Comes a lot of attention and a response to. People. My book, my. First book, Fiber Fueled, has a four week meal plan. It's got about 80 recipes. And people will go and they do that and then they come back and they give you feedback and they say, Dr. B, like many of them, say things that get me really excited and make it all worth it. Like, you changed my life and I opened up my diet and I had been on a restrictive diet. Now I'm eating food again. And I, you know, have never felt better, right? Things like this. And that's just I means the world to me. But there are people who come forward and they say, I don't feel well. And, you know, I'm struggling with this. Food and think it's really important to acknowledge that because it's real. It's not that. There's something wrong with you in the sense that like. Your choices, it's more so that it's my responsibility. If I'm going to ask you to come. Along for the ride to create a framework. And a path where anyone can take. This journey and thrive. And that's going to be a personalized journey. You're you're going to have to find what works. For. You. And it's not going to be the same for all of us. So that was the. Inspiration and motivation for the Fiber Fields Cookbook. And it starts with understanding. The difference between a food intolerance and a food allergy. It's an important distinction. I feel like many times people sort of. Intermix these expressions in terms like even. Sometimes even, you know, people I really respect health professionals. They can do that. So it's quite easy to happen. But you have to separate them. So I'm going to start with a food allergy. We were talking about the immune system earlier. Your immune system. Part of its responsibility is to identify foreign invaders and remove them and response. To them. And the word. Allergy more broadly. Not just in food, but just broadly the word allergy means and triggered excessive response. Of your immune system. To some foreign thing. So it could be like seasonal allergies. And in that setting it's a response to pollen, right? Or it could be a medication allergy and it's a response to that medicine. But when it's food, it's typically a response to. One of the proteins. In the food. Most of the. Time the immune system is responding to a protein, and. There are specific foods that are sort of the classic causes. Of food allergies. So I want to do my best to remember them off the top of my head here. I don't have crisp notes. But they are so at AD one that. If I forget at the A.P., please help me. But yeah, yeah, they are. Dairy. And eggs and fish and. Shellfish and. Wheat. And corn and soy and. Hold on. I think I'm forgetting one. One big one. And nuts and tree nuts. Nuts. Yeah, that's true. Yeah. Yeah. So, okay, so those are the classic food allergens. Now, a quick little side comment about that. Let's think about what we just went through. So dairy eggs, fish and shellfish, wheat, corn. Soy nuts and tree nuts. Okay. Are these not the principal foods. Found in ultra. Processed foods? Like are these not the principal ingredients that make up our ultra processed foods? It's just an interesting association. That I've noticed. And I wonder if the slicing and dicing and reconstruction. Of these foods in ultra processed foods. And mixing them with. Chemicals that frankly, we don't really know what they exactly do to our microbiome or our immune system. If that may be part. Of the reason why these particular foods are the ones that our immune system is so confused about because they're not really seeing them in their native. State. So nonetheless, like those are the classics. And when you when you. Have a food allergy. And you consume whatever that. Food may be, is typically not going to be, all of those is typically going to be, you know, one or a few. When you consume that food, your immune system. Recognizes immediately. It's been trained. It's like, you know, what do you do in here? And it goes. Battle immediately, like full scale, like, okay, unleash the Kraken. Here we. Go. And it'll manifest. In a violent way potentially. So typically, it's not going to be. Like a little minor digestive system, symptom like bloating. Many times it will be severe symptoms that. Could include skin, hives. Could be swelling, swelling of the lips, swelling. Of the. Throat. And, you know, these are things that we as. Medical doctors I know you in your experience as an emergency doctor, you dealt with this more than I ever did. It's scary. People can get really hurt. And one of the important things to understand is that with these types of things, the amount of exposure could be borderline nothing, and that can be enough. To trigger this. Response. This is why. We no longer have. Peanuts on the airplane. It's not that the person who had a peanut allergy was eating the peanuts. It's that by having the peanut on the plane, they could get exposed to such a minor. Amount of those proteins that it could trigger a violent response. And a person who's up in an airplane in the air. And that's scary. And we can't we. Can't have that. So that's an allergy. It's motivated by the immune. System, and intolerance is different. And tolerance by definition does not involve the immune system, which is very important because many people feel like it's inflammation and it's not inflammation. We mean that the immune system is involved. And tolerance is when you eat a food and you get symptoms that. Are undesirable. Classics like classic symptoms. Gas, bloating, discomfort, cramping, possibly diarrhea, maybe constipation, maybe nausea or reflux, acid. Reflux or other symptoms in some cases. But the point. Is that. You eat a food. That food elicits these symptoms. And the question is what. Is going on in between that. Actually triggers those symptoms to take place. And the answer to that question is that in most. Cases and there are some caveats to this that possibly we'll be discussing. But in most cases. What's happening is your body is struggling to process. And digest that food. And this can elicit these types of responses. Now, a food intolerance. Generally speaking, is not going to be dangerous. It is going to affect your quality of life. Which is important. And with these things, it's not the same as a. Food allergy where a little micro dose. Could trigger the symptoms. Instead, it's much more. Forgiving. Than that. There is an amount that you can tolerate, and if you were to consume that particular food in that particular amount, you would be fine. But there's also a threshold, and once you exceed that threshold, you are now in the space. Where your body can't handle it. It's more than your body can do. And now you're going to manifest. With these symptoms. So the classic sort of food intolerance is lactose. Lactose is a sugar that is found in dairy products. And it turns out that 70 to 75%. Of the world. Is lactose intolerant. What does that mean? What that means is that they can consume this, not that. They have a milk allergy. It's that they can consume milk. Or ice cream or whatever dairy product they. Choose. But when they consume it in a normal amount, they get symptoms. Like gas and bloating and diarrhea. And so now that same person, if they reduced, you know, if they did a quarter of a glass of milk or a half of a glass of milk or one scoop of ice cream instead of three. They would be okay if rupi I like to make a quick. Analogy and then we'll see where you want to take it from here. But when I think about these food intolerances, part of the reason. Why they. Exist, again, I am simplifying it here, but part of the reason why they exist is because. Of our gut microbiome. You see. The manifestation. With increasing frequency of these types of issues in people that. Suffer with gut health or digestive health problems like irritable bowel syndrome. And they're in association there. And the reason why is because of the gut microbiome, the gut microbiome is not where it needs to. Be in terms of its ability to help you to. Digest and unpack your. Food and of all the foods that we eat, the foods that. Our gut microbiome we require. The most, we need them the most for fiber. So there's this sort of paradox where we need more fiber in our diet, but when we consume fiber, we need our gut microbes to be able to handle it. And many people who like going. Back to my my. Books and. People who they felt like they weren't doing well, increasing their dietary fiber. The reason why is because their. Gut was not adapted to it and they needed an. Opportunity to adapt to their gut and make it. Stronger. So the analogy that I. Would use here is like. Exercise your gut is like a muscle. It can be trained, it can be made stronger, it can be rehabilitated. When it needs to be rehabilitated. And it's capable of doing incredible things that you perhaps don't realize it can do. But in order. To get there, you have to go through a. Process of systematically. Repeatedly challenging it. And every time you do these small little challenges that are kind of hovering. Right in the area of where that threshold of how much you can tolerate. Every time you do one of those challenges, the threshold moves up, you get a. Little stronger, you become more capable at handling that particular type of food. And it's just like going to the gym. If you were to go to the gym and you hadn't been working out, number one, I. Can assure you. You will be. Sore when you first. Start. It will take you a little time to get used to it because this is a new thing for you, and that's because your body needs. A chance to adapt this new thing that you're asking it to do. But the second thing is, I'm quite sure that you would. Not grab the heaviest weight in the entire. Place. I'm quite sure. That what you would do is you would go in there and you would. Start off with a. Weight that you actually believe that you're capable of doing. And you would do that, and then you would test those limits and slowly increase the amount of weight. And ultimately you would discover what that. Limit is that your body is capable of in the gym. And you would start to push yourself and what you would find is whatever that limit is now it's moving up. Because you're growing stronger. It's the exact. Same concept when it comes to the gut. We have to find. Out what that limit is. We have to then start to. Work within those limits and those bounds. To push ourselves, to challenge ourselves. And as we do that, our gut response. And it grows stronger, just like a muscle. And then next thing you know, you look like a bodybuilder and you're eating whatever you want and you're just, you know, enjoying it. Yeah, yeah, absolutely. That makes no sense. And I guess so there is a temptation to do the quick fix right? Or believe that there is a quick fix in that, you know, I just want to take a test or I just want to do a blood draw and figure out like what? What is going on? What is my food intolerance? And there's no shortage of food intolerance tests out there. I think we can both agree that there are severe limitations to those and actually what you really want to be doing is the thing that takes a lot longer, but is certainly going to get to the root cause of your symptoms. What is that? Can you give us like a sort of an overview of what that process looks like? And then maybe we can dive into some of the key things that you want to rule out before you even go down the path of food intolerance, one of which is obviously an immune mediated food allergy. But assuming that's off the table, maybe you can talk about a few of the other things that you as a casserole. Gastroenterologists want to ensure that, you know, we're not we're not missing. Yeah, yeah. So the process, you know, it is a bit complicated. I wish it were so easy as we just draw some blood and call it a day. And the issue with these tests, just to. Validate what you just said, Ruby. The issue with these tests is that they haven't. Actually demonstrated to us in clinical research studies that they actually can do what they claim they do. So for many years now they have been marketing them and selling them, but without ever stepping forward with actual data to demonstrate that. If you use it in a. Patient of mine, that patient is going to get a benefit. And so if you can't prove that it works, then why would we do that? And many times what I've. Discovered is that these tests create. Confusion, says don't eat this food. And you say, it's. Telling me not to eat this food, but I feel totally fine when I eat it, or it says to you, Eat tons of this food like you have no problem. And you're like, Hold up. Like I feel horrible. And now it's just a confused person because then they say, But the test says, I need to do this. So let's just kind of take that and throw that in the trash and let's move into something that's more reliable. How do you feel? What causes you to feel unwell? Which foods do you feel perfectly fine with? These are the questions that. Ultimately are critically important. And getting to a better. Understanding of that. Relationship with our food and what our unique and personal response to specific. Foods. Are we That's ultimately. Where we want to be because then we are empowered. Then we have understanding of ourselves and who we are, right? Because like I'm I certainly don't have perfect digestion. It's not bad. It's a lot better than it used to be. But I. Also know my limits and I think we all just need to kind of start to grow that understanding. In the Fiber Fields Cookbook, my new book to try to simplify this because again, like I, I think that. We have to come back to sort of like these simple steps and rules. I created a, a a stepwise. Approach. That allows you to move through this. Through this. Process and ultimately find. What works for you. And it's an L, it's a series of of letters called growth gr0. W t h. And every letter counts. For a step in this. Process. So just to walk through this real quick, the first letter is G, and G stands for Genesis. Genesis was a great band. It had some awesome songs. Okay, Now I'm not talking about Phil Collins right now? Although I do love Phil Collins. I think he's great. Huge fan. By Genesis means getting to the root cause. I think it's important like. Many people who go to their health care provider and they want to know what do I do? But the first question should not. Be, what do I do? The first question should be what's what is the problem? What is the root of the issue? And it's beyond just a diagnosis. Right? Like if it's irritable bowel. Syndrome, it's beyond just. That name. It's understanding. Where that your bowel syndrome. Came from. What are the aspects. Of your personal story, your personal journey. That led you to. Where you are today? It's unpacking and looking at the whole person like you and I were discussing, you know, in the very beginning of this episode. Understanding that whole person so that we can. Build a more complete. Picture of how we got to where we are and how we move to. Where we want to be. And so that first step, Genesis is. Building that understanding so that you can start to figure out that path forward. Are IOW restrict, observe. Work it back in. These are the. Basic steps. In a temporary elimination diet. And the reason why we do. These things, everyone's like doctor be elimination. You told us to eat diversity abundance. Yes. But when we're trying to figure. Out what's going on with our body, the most reliable way for us to do that. Is to take the food and basically flip the switch on it a couple of times. Take it away. Do you feel better? Okay, put it back in. Do you feel worse? And when you start to flip the switch a couple of times, in a way, you're becoming a scientist with your own. Body or. A detective, but you also are empowering yourself with that. Understanding of what are the specific foods that you need to work on. Because once you know what you need to work on, you can move to the next step. T train your gut. And it comes back to what we were talking about. A moment ago. Your gut is a muscle. It can be trained, it can be made stronger. How do we do it? Okay, Simply start. Whoa. Go slow. So the food that you struggle with, we drop it. Well, we drop it low so that you're. Dropping below that threshold. So that you're in that safe place where you can feel good eating that food. But at the same time, you are now. Exposing your microbes to that food. Even though you feel fine. These microbes are down, they're working. And as they work, they become more efficient and more skilled. More powerful at unpacking and digesting that food. So when you go slow, you're able to escalate. The amount of that food over the over the course of time. And you find that much like with exercise. These microbes, they come along for the ride because they have grown stronger and more capable. And finally, the. Last letter in my acronym, I blanked on the word acronym earlier. I was. Having a moment there so that the last letter in my acronym, Growth is H, which. Stands for Holistic Healing. And again, what we. Come back to is that I want to. Look at the complete person, and this is my friendly reminder. This is actually my favorite letter out of the whole thing. I want to I want to. Come back to and say. That you. Are more than just varieties of plants or grams of fiber or digestive enzymes or biochemistry or microbes. You are so, so much. More than that. You are a complete person. And that complete. Person really impacts and in a powerful way, who you are, how you feel. And even your your digestion and your gut health. And so this includes looking. At things like sleep and exercise, but in a very powerful way. I also want to look at your relationship with your food and whether or not that's a healthy relationship. Because if food is. Causing anxiety or fear in your life and we are not where we need to. Be, and I want to look at your stress levels and acknowledge. That. Maybe you haven't thought of this, but if there is something in. Your life that is upsetting you and causing trouble. And it could be like very. Here and now, like stress in the workplace, stress in a relationship, whatever it may be, you know, someone in your family that you care about, that it's not where they want to be. And that's troubling. You could be here now, and that's very conscious, but it could also be something. That has occurred in your past that you've kind of swept under the rug. Into an unconscious space. And in the unconscious space, it's still. Actually there causing trouble. Because you kind of. Felt like you'd gone. Past it, but it's still. There. You haven't dealt with it and it is causing ongoing stress for you. And the point is that through the brain gut connection, you. Actually can, through your stress. Responses, manifest injury to your gut microbiome. And it's just a kind of. Illustrate this real quick. You know, if you and I or anyone else where to go and speak publicly, I'm pretty comfortable it now. But when I was younger I was not. It really scared me. And I would get a queasiness in my stomach and the queasiness would turn. Into a little ball that was the size of a golf ball. But then it would grow and I would feel horrible and I would have to go to the bathroom right before I went on stage. And that that is actually. A very clear illustration of the brain gut connection. Because it's the anxiety and stress that are actually hijacking. Your digestive system and your gut and then manifesting these symptoms there. So what happens. If we have that sort of ongoing smoldering stress. Which maybe is not so acute, but it is. Chronic and it's always there. You end up with the same type of issue and it's just but because it's. Chronic stress, it manifests with chronic digestive problems. So I think it's. You know, I think that the message here for people is that. The bringing a full. Full circle back to the letter G in Genesis, that understanding the root of your problem. Is. The key to building the right solution. And if the root of the problem is not in fact your digestion. If the root of the problem is. In fact a different part of your body, that's your digestion, like the brain gut connection, then we need to acknowledge. That so that that becomes. The focus of our. Plan. And I have Ruby, I'm Sure. You've seen this. I have seen this many. Times in my career. Where the person, yeah, if they're failing and they've done everything right. Dr. B I eat the diet, ask me to, I sleep, I exercise, I meditate, I do yoga, not better. And then you. Discover that they're unhappy in their job and their boss is berating them and they change their job and they get. Better. I've seen it many times. Yeah, yeah, yeah. I think this is such an important point, you know, just to go through all that. The genesis, trying to find the root cause, the tactics within that to look at physical issues that could be causing the symptoms themselves, creating that flexibility and the adaptability of of a gut this able to digest multiple different things. That's why I'm quite like privileged and happy to be able to like have my healthy foods. But I can still tolerate, you know, your day well, I'll have a burger or I'll have like pasta or like I'll have some gelato. Like my my gut is is has been trained such that it can tolerate a plethora of different ingredients. And I've got to, you know, lucky to have a good relationship with food. But then there's that H which is, you know, how do other elements of our life impact are the the manifestation of physical symptoms? And I think that doesn't get talked about nowhere near about as enough. So I was really grateful to see that and the sort of that the tips and tricks that you have within that to sort of a find out where that might be in your life as well as the the solutions that you offer as well, going back to the genesis of those symptoms. So let's say someone does need to restrict for a certain amount of time, how long are we talking? What kind of things do you sort of suggest to to look for? And the observe letter and the acronym and then the tips from reintroduction? And before actually before we get onto that, I just wanted to talk about those those there's things to rule out before you even start an elimination or type of an elimination diet as well. Yeah, yeah, yeah. So we'll go. Through these first sort of four letters here, gr0w genesis, restrict, observe, work back. End. So the reason why I start with Genesis, you know, again, this is more than. Just sort of a philosophical thing of, oh, you have to know, you know, what your problem is so that you can build a plan. I mean. That is, that is actually true. And I do really sincerely believe that. But it's also that, you know, if a person were to come. In and. They say. Dr. B, I am I'm bloated. I'm gassy. I'm having a little bit of queasiness and nausea. Lots of fatigue. And I feel like every single. High fiber food is causing trouble for me. Like all of them. Okay. So in this person, as I sit here and. It's kind of like running through my brain and it's a pattern recognition thing. I already have the diagnosis that I suspect it to be, and the answer is constipation. I believe that this person is constipated. And it's an important thing to identify and understand, because in this person, the reason why they're struggling with fiber is because. They're not moving their. Bowels. If you take a person who is not moving. Their bowels. And you start pouring fiber in there, if it gets their bowels moving, they will be good. And this is the. Reason why. Fiber is often oftentimes the first thing. Recommended for people who are constipated. But there are these people and they tend to be the ones that. Come to a gastroenterologist. Where they don't. Have miles constipation, they have moderate or severe constipation, and when they start pouring, the fiber in there actually doesn't move their bowels. And then what happens is the fiber there and it produces even more gas and they feel unwell and they attribute. That to the food the food is causing my problem and I understand how they feel. But in this setting, if you diagnose the constipation first and you treat the constipation first before. Tinkering with the diet. You will actually get them. Feeling way better. The gas and the bloating will improve. And this concept of a food intolerance that they think that they have. I my experience is that it actually goes away almost entirely in most. Cases, and suddenly they're able to tolerate their food. Why? Because they're back in their rhythm, because they're moving their bowels. And when they're moving their bowels, then you can get back to normal digestion and you can consume that fiber and the fiber goes through that normal process of being unpacked. And now it's the fiber is your friends because you're feeding your microbes and you're getting. Back to good regular bowel. Movements. But the key here is that with that particular person who's constipated, I would actually never recommend that they restrict. Observe for work, get back in. First, because that's not really the problem. The problem is constipation. Let's fix the constipation. And then if there's still some issues, more than likely what was all fiber has now been distilled down to. I don't feel well when I consume garlic. Okay, cool. We'll focus on that now. Right. And that's where you apply the restrict observe working back end. So this letter Genesis, I want people to think about like and rule out make sure that it's not there are these things that potentially can really impact our digestion because if you address them adequately, your digestion will improve and you may find that you don't have to. Go through the rigors of the entire growth strategy. You get to G, you handle your business and you move on with your life, right? So some of these rupi I mentioned in the Fiber Fields cookbook. There are really. Three main ones that I talk about, and that includes constipation. Number two, celiac disease. Celiac disease is where your immune system is reacting to the presence of gluten. By the way, gluten is a protein that is found in wheat, barley and rye. And so when people consume wheat based products. Which, by the way, are everywhere. Then because they consume. Wheat that contains gluten and that gluten activates their immune system and then they don't feel well if they have health related issues as a result of that. In that person. If you identify and. Diagnose. The celiac disease. And they go on a gluten free. Diet, they're like the. Vast majority of the time. You have. Completely fixed the problem. Mm hmm. So it's a matter. Of proper identification, identification and then implementing the treatment for that particular issue. The third thing is. Gallbladder related issues. So I have. Discovered that gallbladder related issues can manifest. In many different. You and I were taught in medical school. That when people. Have a gallbladder problem. It is they eat a meal. Classically, it's a high fat meal. They get pain. That pain is in the right upper quadrant of their abdomen. It might radiate to their back. And it's intense and it's sharp. That's the gallbladder. Story. And my. Experience as a guest urologist is that of the people who had. Gallbladder issues. That was maybe 15%. And the vast majority of the time. It. Was something more nebulous, but it typically did involve pain in most cases. In some cases it was. More. Like nausea or in. Very rare. Cases, it was almost like acid reflux. But if you have pain, particularly right upper abdomen, middle center abdomen, right side on the back. Or even in the right lower abdomen. And you have not been tested to check on your gallbladder. It certainly needs to be considered. And one of the little tricks. That I have discovered through the years that really sort of tunes me into the gallbladder. Is when people wake. Up at three in the morning, the pain. Because the thing. About the gallbladder is that it just doesn't care what time it is. It doesn't. And you could take a person. With the worst irritable bowel syndrome in the world, the worst. But once they go to bed, they will sleep and their condition will. Not wake them up with pain. But on the flip side. The gallbladder will wake you up in the middle of the night. So if you. Kind of have this this type of discomfort, just be aware and conscious. And again, what I come back. To, Ruby, is. You could take that person. And they feel like they have a food intolerance and they go down this. Complicated path. Of trying to figure out their food. Intolerance. Yet if it's the gallbladder, that's the root of their problem. We need to address that and they won't be better until we do. So. Just restriction of how long? It depends. Most of the time when we restrict. What we're doing here is. We're trying to create a. Counterpoint. Against our. Typical. Diet. So coming back to being like a scientist. Or a detective. You have your baseline diet and then what do you want to test whatever it is that you want to test, whatever it is that you suspect could be the issue. What's poor to weigh? And let's take note. Meaning observe. Let's take note of the difference in how we feel. Relative to where we were and. That restriction process. Typically, you want to give yourself at least two weeks. In some cases, it can. Go longer to potentially. Six weeks, but it kind of also depends. On the restrictive nature of the diet. So as a quick example, I make the recipes in my books are entirely plant based. Now, let me just kind of comment on this quickly. If you read my first book. I'm kind of giving away the punchline. But the punchline of my first book is. I want to meet you where you are. I want to help you move in this direction. And ultimately, where you choose to settle should be a place that makes you really happy and you feel well, but also is a healthful diet. To me, a. Predominantly plant based diet is a healthful diet. When you get up to 90% plants, there just is. Absolutely no contention from my perspective, whether or not you have a healthy diet. It is a healthy diet. And whatever constitutes that last 10% is really up to you and what and what works. So while my recipes may be plant based, if you take. My plant based recipes and you want to add in additional things like a chicken or shrimp or whatever it may be, I have zero problem with that at all. This is not. An all or. Nothing thing, but if you were to go. On to a restrictive dietary pattern where, for example, like in the Fiber Foods. Cookbook, it is a plant based low-fodmap protocol, and because it's. A plant based low-fodmap full acknowledgment, for me it is more restrictive than if you were to include, for example, chicken and shrimp and dairy products and. Things like this. And for that reason, I don't actually want you to do six. Weeks of a plant based low-fodmap protocol I want you to do too. So that we can. Get the information that we need. And then we can move forward. So typically, 2 to 6. Weeks is going to be the answer for how long. And, you know, during this time, throughout all. Of this, whether you are restricting or you are working, something back in will. Be better over observation. It is across the board. You are always observing how you feel and it's a reminder that it is actually quite helpful to kind of keep notes and perhaps keep a food diary. And so and then finally, when you work it back in the in this setting, when we talk about restrict. Observe, we're going back in. We're really saying challenge your body, answer the question, is this a problem for you? And if it were, for example, a fodmap challenge, you would take that particular food that you are asking the question, do I have a. Problem, for example, with garlic? And you would introduce it incrementally and see how you respond. And if you're able to tolerate only a small amount at least you know. What that amount is. And if you're able to tolerate a full amount like you don't, I don't. Really want you to cook with ten garlic cloves. In one. Like that's not there's not health that would make any of us feel horrible. Okay. But if you. Are able to tolerate a normal amount, say one clove of garlic in a dish. Then you know that this. Is a food that you're able to tolerate. And that's. That's the information that you're trying to get to, is that understanding of. Which foods you do. Well with and which foods are a challenge for you? And when they are a challenge for you, it's not just whether or not they're a challenge. You also the follow up question is how much are you able tolerate? Because now you sort of know what that threshold is. It can work to build that threshold up over time. Yeah, yeah, that makes a ton of sense. And you can kind of see why a lot of people struggle with elimination diets in general because it does require quite a bit of motivation and dedication and you know that that sort of scientific nature of, okay, I'm going to tinker with this, I'm going to add this, I'm going to wait a bit to take a food diary and then going to try the next one. It's like you can understand why, like, oh, well, this company is just selling me a quick test and I can find out in 2 minutes and just be done with it. And so you can understand sort of the motivations, but it's good to hear it from yourself. Having seen thousands of patients in your clinical careers like this is the way to do it. Slow. It does require a lot of effort, but this is, if you want ultimately the success and the flexibility of a the digestive system that is adaptable, adaptable to multiple ingredients. And this is certainly the way to go. Diving into the observed section are the key symptoms that you ask people to look for specifically fatigue, bloating in our habits. Are there certain things that you're like, You should really write this down. Your food diary and figure out, you know, how this is changing on a day by day basis? Yeah, this is a great question. So if I were to distill. Down digestion, digest of health into. Only one symptom, if you're only giving me one, I'll take this. Symptom of gas and bloating. Because I tend to find that anyone. Who's struggling from a digestive perspective. There's going. To be some level of gas and bloating. And when they're better, like for example, with constipation people classically have gas and bloating almost all. And I know that they're better when the gas and bloating is gone, Right? That that is the measure of digestive health is when you can eat in abundance without restriction and without suffering any unwanted symptoms. You have digestive health, which I feel like real quick reviews the concepts. That people have confused on the internet because they do things like say, Oh, well, I eliminated all plants, eliminated all plants and went carnivore and it fixed my gut. It didn't fix your gut because if you tried to eat those plants, you would. Actually feel horrible and you actually probably would feel worse than you did. Before, right. So you actually haven't. You haven't made your gut stronger. What you've done is you've avoided these foods. And when you. When you avoid these. Foods, you are actually compromising on the health of your microbiome and you're compromising on nutritional quality. And those are things that don't necessarily show up in one week. But I do worry about the effect of those things in the long haul and broad human health, because at the end of day, I just want people to be happy, healthy and live long lives. So anyway, what is the. Information, though, that I seek to collect when I'm observing. In the Fiber Fields Cookbook? I give an example of what this might look like. But effectively I want to know what you're eating. I want to know what the symptoms are after eating the window of time, from my perspective is out. To 3 hours is where I'm really. Focused. I also want to know so like gas and bloating would certainly. Be one of them. I would think about discomfort and where that discomfort is. Nausea. I want to pay attention to bowel movements. When you go, how often you go, what does the bowel movement look like? That may be a bizarre thing to some people. There's a way that. We measure it. I know that you know this. It's called the Bristol Stool Scale. And. You can you can actually like with imagery, look at the pictures of seven different types of movements and assign a. Number from one. To seven. And that number provides insight like a type one bowel movement is a very constipated bowel movement. It's a hard ball. And a Type seven bowel. Movement is almost straight water that's diarrhea. And yet the full spectrum. With type. Four right in the middle being the the bowel movement we're striving towards, which is. Soft forms, sausage shaped and with bowel movements. I also want to know like, how do you feel? Do you feel like you really went? Do you feel like you didn't completely empty? Do you feel good? You should. It's supposed to be a pleasurable thing. Supposed to be one of the. Highlights of your morning or your day. And when it's a struggle and you're sweating, sweating and working hard. Then we have work to do because we're not where we need to be. So I want to know about bowel movements, frequency, what Bristol type. Whether or not you feel like you're completely emptied. How do you feel around the bowel movement? Do you feel better. After bowel movement? The way? Is it really important, like sort of a trick that I've used in my career for the people listening at home, Like if you have. Digestive. Symptoms, but if you're way better after about movement for a couple of hours and then those symptoms start to come back again, your body is telling you you need to have more good, complete regular bowel movements. We need to get things moving. And then I think it's important to to put. How we feel into a framework of context. So coming back to some of these things that like holistic healing, we're talking about more than just what you eat and how you feel. We're coming back to the fact that you were a complete person was look at that complete person. Did you sleep last night? Did you get a good night's rest? How many hours was it? Did you wake up at night? Did you have any sort of ruminating. Thoughts, exercise? Were you able to get in some activity? Literally, a walk counts. I celebrate. I think, like people underestimate. The value of a walk. A walk is very valuable and stress, you know, kind of where are you at? Is there anything in your life that you feel is troubling you? Because if there is, then you should expect that your digestive. When you're in a place where you're feeling troubled by your. Stress, you should expect that your capacity. To digest and processed foods is not going to be where it needs to be. So yeah. To me those are the. Things I would work up. Yeah, I think that's a really important point there. You should expect that your digestive system is not going to be working properly if you are stressed, and I think that's a really important consideration. I want to bring this conversation it to a close, but I did want to touch on a histamine intolerance. It's been brought on my onto my radar by patients actually who sort of inform me about it as a lot of this stuff actually, you know, certain elements of nutrition. You know, I'm always sort of listening out for what people are talking about and not just on social media, but I care in clinic because I really feel like it, you know, filters down from multiple sources. And I wonder if we could talk a bit about what histamine is, how one might be sort of diagnosed or think about histamine intolerance as a as a contributing factor towards symptoms, how varied those are and and how you sought to give people a guide as to essentially along the same growth process, how they can potentially rid themselves or lower their the incidence of of histamine related symptoms. Yeah. You know, one of the things about my my book, the Fairfield's Cookbook, is that. It became a protocol. You know, originally it was going to be a cookbook and I didn't really know what to call it because it feels like it's not exactly a cookbook. And yes, it does have. 100 recipes and it has color. Photos, but it became this protocol. Where the chapters are unpacking the growth strategy. And as I walk you through that, I am going to guide to these specific dietary protocols that you can apply using the growth strategy. So it's like, yeah, there's all. These recipes that are plant based and, diverse and, you know, a lot of different. Plants, but I also have specific. Sections for Fodmaps and for Histamines. To help people. Identify and understand whether or not this is an issue for you. And a quick comment on histamines. Before we dig into the nitty gritty. Histamine is very complex. It would be hard. For us to cover this in a way that I feel like I've done my complete conversation in the next 10 minutes. But I think it's important for people to. Understand that. These types of. Approaches, like, for example, Fodmap. We're all trying to figure this out and nutrition research. Hasn't received the funding that we wish that it would receive. And it takes time. And there's a maturation process in our understanding. If you went back ten years ago, fodmaps like. There were many people that were skeptical that this was a real thing. It came out of. Australia, Monash University. I think they were more accepting of it in Australia first. But many people, like in the States, were just like, Yeah, what does that even mean? You have to prove it. And I think we're kind. Of right there with histamine intolerance. That there's a building momentum, but we're still. Very early stages with histamine intolerance. There's a lot that we don't know, but I felt compelled to include this in my book. And the reason why is because I think that there's. Enough there for me to say that I. Do believe that this is real. Unfortunately, there's not a blood test to prove that. But there are people who. Clearly suffer with these. Issues and they have reached out to me since reading my book. And this is when I feel. Really, really good as an author. Because when people say to me you changed. My life with that chapter. Then I say, I'm so glad that I included it. And so histamine histamine intolerance is again coming back to this idea of a threshold. There is histamine in our food. Histamine, by the way. Is a molecule. That is innate in our body. We have histamine in our. Blood, literally right now, all. Of us, every single one of us. And it's a part of our immune. It's also a signaling molecule. It can affect our brain, it can affect our digestion, and again, it can affect our immune system. When people have acid reflux, the old school medicines that sometimes we still reach. For and. Use, recalled Histamine two receptor antagonists, H2 receptor antagonists. Because if you block that H2 receptor, the histamine receptor, you reduce stomach acid. When people have allergic symptoms, we reach for histamine One blocking agents like the classic is diphenhydramine, which is Benadryl. But we also know how. These longer acting ones like Cetirizine and we're at that time. I don't know what they're. Called in the UK. Perhaps you could do you know, Rupay but those are in the UK the same actually. So Loratadine has got some trade names, but we tend to use the generics and Sydnor is in and yeah, very similar. Okay, got it. Got it. So yeah, so like in the U.S., those are. Zyrtec and and I believe Claritin and so user take Claritin Allegra. So anyway so you can see that histamine. Is a part of your body. Well histamine is also in food is the mean is in food because food protein contains amino acids as the. Building blocks of protein. And one of the amino acids is called histidine. Sounds a little bit different. I was trying to accentuate that a little bit. I apologize if if it came out weird, but histidine and E a little bit different than histamine any histidine is an amino acid and you'll find it. You know, basically in all food and. Microbes that exist, like our world is ubiquitously covered with microbes. Everywhere we go, there are microbes. A an apple has a microbiome. If you were to harvest fish, there are microbes on the fish. And these microbes have enzymes that are capable of taking the histidine and turning it into histamine. So there can be a histamine supply that exists within your food. All foods contain. Histamine. There's never been food. That did not contain histamine. It's just varying amounts. The classic foods that contain histamine. Are the ones that are exposed to microbes. The most like fermented foods. Now that includes the classic ferments like sauerkraut, kimchi, miso. Tempeh, yogurt. Cheeses, kefir. All right. Those are classic ferments. But also, let's not forget. That vinegar and alcohol in chocolate. Those are ferments also. And so those are all high histamine foods. The other classic is fish. Fish. They catch the fish and they put it on the ice and as the fish sits there on ice, unless it is frozen immediately. These microbes are transforming. The histidine. Into histamine. And so there's a more acute, more intense, more. Violent. Version of histamine intolerance called scab roid poisoning or histamine. It's rare, it's not common, but when it does. Occur, it tends to be a bad supply of fish. That is the number one cause. So anyway, histamine exists our food and when we consume this histamine, our body has the. Ability to. Handle a certain amount of histamine. But it appears that in people that have digestive health problems such as irritable bowel syndrome, they may not have the ability to handle much as other people. And so this excess burden of histamine can manifest with symptoms. But what's interesting about this. Particular that makes it different. And that, you know, really sort of motivated me to put this into the. Book so that I could help these people. Is that it affects more than. Just your digestion. It can be a whole body experience. So, yes, gas and. Bloating and discomfort and diarrhea can be related to histamine intolerance. And if you experience those symptoms and you don't know why, then this would be something that you might consider. But going beyond that, outside of the gut, headaches, classic migraines, classic runny nose, sinus issues, you eat food, you get congested. That could be histamine related cough, skin rash, hives, flushing cardiovascular stuff like your heart. Meaning like rapid heart rate. Lightheadedness in women. Actually, histamine is very strongly tied to their menstrual cycle, very strongly tied. To the. Hormone estrogen. So women actually get a surge of histamine intolerance typically during the premenstrual phase. So if you notice that you're getting or the other time is, by the way, ovulation. If you notice that you get headaches, headaches at the time of ideation, headaches at the time of premenstrual or worsening of your menstrual symptoms that can be histamine motivated. So trying to close this off real quick loop Rupi in the interest of time, we apply the same concepts. You know, what you do is you ask, is this possible? Could this be the genesis of my symptoms? And if you have several of the symptoms that I just described, then you have to consider this. So what do you do? Well, again, there's no blood test. Or CAT scan or anything to make it easy for you to just walk into your doctor, get your test, walk out and have your. Answer. You have to go through the process of doing a temporary. Restriction of histamine containing foods, observing how you feel, and then working them back in. And that's what I laid out in the cookbook, is a means. For people because there's, I believe 24 or 20. Six low histamine recipes like this can be very. Complicated. You don't know what to eat, what you're supposed to eat, How do you do it? Okay, cool. Like I get that. Like your doctor is never going to like, say. Here's the use your low histamine recipes. They might say, here's the high histamine foods and then you don't what to do. All right, let me make this super simple. If these recipes do it for ideally two weeks, at least one, but ideally two weeks, see how you feel. If feel way better, right? Then to me it's like, okay, first of all, how you feel is how you. Feel and that's important. And second of all. We may have just. Figured out what the source of your problem. Is. And if that is true, then we have. Taken a major step towards better days for you. And that's what we want. Yeah, absolutely. I mean, yeah, I'm really glad you put that in the book because I think navigating high and low histamine ingredients is is difficult enough because it's just not that well known about. And I think you just made it super easy and I think all the while knowing that to really get to the root cause, going back full circle to the genesis of the issues, you want to try and reintroduce to the men in small doses and then measure and see how you do it. And then you've laid it out really well in the cookbook. Well, this has been super fun. We're going to do this at some point in the future, hopefully in person. When you're down in London, be lovely to do coffee. One of my recipes and I will get your your feedback on that as well alive. That would be awesome. But thank you very much for your time. I really do appreciate it and I wish you the best of luck with the book and I can't wait to help promote it for you. Over here, across the pond. Thank you, my friends. And you think you first of all, to. Everyone who listens to us here today. If you want to. Learn more or follow my work, there are resources that I have that are completely available to everyone so you can follow me on social media. Go help them be. I have a tick tock. I just started it and that one is the nice. Yeah. I'm not doing the dances yet. I don't have the fuel tools for that. But but I am sharing knowledge there. So the help them, the underscore is I think some probably. Like 12 year old kids took my. Sugar, took my account and then if you go to my website, the playing field, God, I have a free email newsletter. I do have some other free that are there intended intending to help people. And I also for those who are like interested in diving beyond the book, for. Those who have read the book and they want to go beyond the book, I have courses now that deal with diagnosing your food intolerance, the deal with going beyond the Low-Fodmap diet that's in the book to go into that higher. Level and dealing. With histamine tolerance beyond the book. So I do try to build out these. Resources and it's, you know, really at the end of the day, the goal is just to try to create ways that people can empower themselves with the right information. Not in the absence of health care provider, but in conjunction as a supplement. To working with their health care provider to ultimately accomplish their goals. Feel better, live a better life. That's that's what we all want. I think. Now that's awesome and we'll link to all those resources in the show notes and yeah, thank you once again. Man, this is this is epic.

Channel: The Doctor's Kitchen

Views: 18,143

Keywords: the doctors kitchen, dr rupy aujla, healthy eating, healthy cooking show, eating for health, how to cook healthy, doctors kitchen, quick meals, healthy food, how to eat for, food as medicine, nutritional medicine, food and medicine, food is medicine, what to eat for, anti ageing, plant based, 321

Id: nKC8Y1hKSfI

Length: 113min 33sec (6813 seconds)

Published: Wed Feb 01 2023